Annals of Plastic Surgery

BACKGROUND: Open fractures of the lower limb represent a common challenge for trauma centers. Even where national guidelines are available, these standards are frequently missing. Our study evaluates the influence of polytrauma on the adherence to the timing and management required in an orthoplastic approach. PATIENTS AND METHODS: A retrospective review was performed on 36 patients affected by a Gustilo-Anderson grade IIIA, IIIB, or IIIC fracture of the lower limb between 2018 and 2022...

No abstract text is available yet for this article.

PURPOSE: Gender-affirming bottom surgeries (GABS) play a central role in treating gender dysphoria to improve quality of life for transgender and nonbinary (TGNB) patients. However, there exists limited data on operative risks and outcomes for patient populations undergoing GABS. The goal of this study is to identify sociodemographic and clinical risk factors for determining 30-day postoperative complications in patients undergoing GABS. METHODS: The ACS-NSQIP database from 2010 to 2020 was used to identify patients undergoing gender affirmation surgery (GAS) using Current Procedural Terminology (CPT) codes included in transfeminine and transmasculine bottom surgery...

INTRODUCTION: Scaphoid nonunion is a typical complication of scaphoid fractures, with the nonunion rate varying by the location of the scaphoid. The current widely used method for treating scaphoid nonunion, which is challenging for surgeons, is the headless compression screw (HCS). Various surgical approaches, such as the scaphoid plate, have been proposed to address the problem of screw fixation; however, no consensus exists regarding the optimal treatment method. This study focused on analyzing appropriate treatment methods based on the anatomical location of the scaphoid nonunion...

STUDY DESIGN: Systematic, scoping literature review and case presentation. OBJECTIVE: The goal of this study is to review current literature on management trends and outcomes of pediatric intranasal lobular capillary hemangioma (ILCH). CASE PRESENTATION: A 14-year-old male patient presented with a 15-month history of unilateral epistaxis, nasal congestion, and mouth breathing. Further workup revealed a pale nasal mass obstructing the right nasal cavity...

BACKGROUND: The 8th rib cartilage was sometimes insufficient to construct a complete external helix in ear reconstruction for microtia. The aim of this study was to investigate the splicing technique of 8th rib cartilage in modified Nagata method stage I. METHODS: Between September 2022 and May 2023, 231 consecutive patients with microtia underwent auricular reconstruction with modified Nagata method stage I. Thirty-four patients with insufficient 8th rib cartilage were screened out by three-dimensional (3D) computed tomography preoperatively, who were included in the study prospectively...

No abstract text is available yet for this article.

BACKGROUND: An ideal 3D cartilage framework and accurate anatomical location are the most important factors to carry out a satisfactory reconstruction of the ear. To streamline this process, we developed an augmented reality assistance system, HoloLens Ear Image Guidance, which is based on computed tomography (CT) data, tailor-made navigation kits to guide reconstruction, data processing software, and HoloLens hardware. The objective of this study is to verify its feasibility in a clinical setting...

Microsurgery is a unique and specific surgical skill, known to have a steep learning curve. Surgical trainees may wish to undertake a microsurgical skills course to learn the rudiments of microsurgery and to direct future practice and skill acquisition. The National Microsurgery Course in Newcastle, United Kingdom, aims to equip early-year surgical trainees with basic microsurgical skills including tissue handling, vessel anastomosis, and nerve coaptation. The course in 2024 gave delegates an excellent opportunity to learn and practice these skills in a well-resourced environment with a high delegate-to-faculty ratio...

BACKGROUND: Operative microscopes are traditionally draped in single-use plastic to prevent infection theoretically. The necessity of this routine in breast free flap surgery is unclear. Alternatively, sterile wrapping of microscope handles would reduce operating room waste and provide a more cost-effective and environmentally sustainable approach to sterility. This study aimed to determine whether the draping technique used during abdominally based free flaps (Ab-FF) influenced the rate of surgical site infections...

BACKGROUND: Collagenase Clostridium histolyticum (CCH) injection, an effective enzymatic fasciotomy treatment for Dupuytren disease (DD), was abruptly withdrawn from the healthcare market outside the United States in 2020. The impact on patients, physicians and hospitals of this helpful surgical alternative no longer being available has been little studied. METHODS: To investigate the impact of the withdrawal of CCH in Japan, we used the National Database Open Data Japan from 2014 to 2020...

BACKGROUND: Policy impacting traditional Medicare beneficiaries may have unintended effects for privately insured patients. After the repeal of a longstanding $1500 outpatient therapy cap in 2018, we aimed to evaluate if this policy change was associated with differences in use of cost of postoperative therapy after common hand surgeries, including carpal tunnel release, trigger finger release, ganglion cyst excision, De Quervain tenosynovitis release, carpometacarpal arthroplasty, and distal radius fracture open reduction/internal fixation or percutaneous pinning...

INTRODUCTION: The deep inferior epigastric perforator (DIEP) flap is currently one of the main options in breast reconstruction. The information about this surgery is critical for the patient, in order to choose the breast reconstruction method. Our study aims to analyze and compare the quality and accuracy of the information related to the DIEP flap reconstruction method provided by social media platforms (SMPs) and the new large language models (LLMs). MATERIALS AND METHODS: A total of 50 videos in English and Spanish were selected from the main SMPs (YouTube, Instagram, and Facebook) using the keywords "DIEP flap" and "colgajo DIEP...

BACKGROUND: Hand injuries pose challenges due to complexity and aesthetic-functional concerns. Dorsum of hand injuries are difficult to treat due to thin skin cover and increased propensity to exposure of underlying structures. Perforator-based flaps can provide better outcomes with minimal donor site morbidity. This study aims to bridge the gap in anatomical knowledge and explore the potential benefits of dorsal carpal artery perforator flap. MATERIALS AND METHODS: A prospective study was done from July 2021 to June 2023, focused on study of dorsal carpal artery perforators on 12 fresh frozen cadaveric hands...

INTRODUCTION: Gliding brow lift (GBL) has become one of the most popular techniques for eyebrow lifting in recent years. Despite the widespread use of the technique, there are a few publications in the literature. This systematic review was conducted to present current data on GBL and determine its place among brow lift procedures. METHOD: GBL-related studies were searched in PubMed, Google Scholar, Web of Science, and Scopus databases. The screening was carried out from January 2019 to December 2023...

BACKGROUND: Fat grafting is a highly versatile option in the reconstructive armamentarium but with unpredictable retention rates and outcomes. The primary outcome of this systematic review was to assess whether secondary mechanically processed lipoaspirate favorably enhances the vasculogenic potential of fat grafts when compared to unprocessed lipoaspirate or fat grafts prepared using centrifugation alone. The secondary outcome was to assess the evidence around graft retention and improved outcomes when comparing the aforementioned groups...

BACKGROUND: Only upper blepharoplasty can cause a change in the eyebrow position, so browpexy can be combined with blepharoplasty in selected patients. There are many brow lifting techniques, both surgical and nonsurgical, and internal browpexy is one of the most widely used surgical brow lifting techniques. The purpose of this study was to evaluate the change in brow position after upper blepharoplasty with or without internal browpexy using preoperative and postoperative photographs...

OBJECTIVE: Severe hand electrical injuries often occur in functional areas such as joints; the repair requires attention to both appearance and function due to the visibility of the hand. This study aimed to present the clinical experience of successfully repairing hand electrical injuries using improved forearm venous flaps. METHODS: From 2020 to 2022, 15 cases of severe hand electrical injuries were diagnosed, including 10 males and 5 females. Among them, 6 cases were repaired in the first web space, 4 in the thumb, 3 in the index finger, 2 in the middle finger, 2 in the ring finger, and 2 in the little finger...

The Brussels Breast Surgery Fellowship at Brussels University Hospital offers a unique 3-month clinical immersion in reconstructive and aesthetic breast surgery. Under the guidance of fellowship director Prof. Moustapha Hamdi and his esteemed colleagues, the fellow is exposed to a high volume and wide breadth of cases spanning autologous and implant-based breast reconstruction, oncoplastic surgery, breast reduction and mastopexy, implant augmentation, revision breast surgery, and fat grafting. The multidisciplinary team approach, involving close collaboration with breast surgeons, provides valuable experience in oncoplastic planning and execution...

BACKGROUND: The aim of the study is to assess the possible predictors of microvascular free flap failure and determine the critical postoperative timing of flap failure, thereby minimizing this adverse outcome. METHODS: This is a retrospective single-institutional review of 1569 free flap operations. All free flaps with outcome status recorded were analyzed for possible predictors in the development of microvascular compromise. Compromised cases were then analyzed for differences in time to compromise and time to theater takeback between salvaged versus failed free flaps...